Objectives:
Patients with established Parkinson’s disease (PD) display differences in peripheral blood biomarkers of immune function, including leukocyte differential counts, compared to controls. These differences may be useful biomarkers to predict PD and shed light on pathogenesis. We sought to identify whether peripheral immune dysregulation was associated with increased risk of subsequent PD diagnosis.
Methods:
We examined the relationship between incident PD and baseline differential leukocyte count and other blood markers of acute inflammation in UK Biobank, a longitudinal cohort with >500 000 participants. We used a range of sensitivity analyses and Mendelian randomization (MR) to further explore the nature of associations.
Results:
After excluding individuals with comorbidities which could influence biomarkers of inflammation, 465 incident PD cases and 312,125 controls remained. Lower lymphocyte count was associated with increased risk of subsequent PD diagnosis (per 1‐SD decrease in lymphocyte count OR 1.18, 95% CI 1.07‐1.32, padjusted=0.01). There was some evidence that reductions in eosinophil and monocyte counts and CRP were associated with increased PD risk, as was higher neutrophil count. Only the association between lower lymphocyte count and increased PD risk remained robust to sensitivity analyses. MR suggested that the effect of lower lymphocyte count on PD risk may be causal (per 1‐SD decrease in lymphocyte count; ORMR 1.09, 95% CI 1.01‐1.18, p=0.02).
Interpretation:
We provide converging evidence from observational analyses in UKB and MR that lower lymphocyte count is associated with an increased risk of subsequent PD
